2. Post operative care
• Post anesthesia care
• Oxygen and fluid
• Pain management
• Immediate assessment- including airway,
breathing, circulation and others (level of
consciousness)
• Nursing diagnosis
• Nursing care plan
• Nursing care in post anesthetic care unit
• Transfer from the post anesthetic care unit to
postoperative ward
3. Monitoring during the anesthesia and in
the recovery room
The goal of post anesthesia nursing is to assist
a non complicated return to safe physiological
function after an anesthetic procedure by
providing safe, knowledgeable, individualized
nursing care for clients and their family
members in the immediate post anesthetic
phase.
4. Contd...
The post operative phase of surgery is the
final phase of surgical experience. Nursing
plays a critical role in returning the client to an
optimum level of functioning. The
postoperative period may be divided into two
phases i.e immediate post anesthesia phase
and postoperative period, and later in
postoperative phase.
5. Equipments used in PACU
The PACU nurse prepares and checks the
function of following equipment:
• Sphygmomanometer
• Pulse oximeter
• Stethoscope
• Cardiac monitor and electrodes
• Intravenous equipment
• Suction equipment
• medications
6. Contd…
• Emesis basin, mouth wipes, urinals, bed pan
• Thermometer
• Warmed blankets or electric warming
• Emergency equipment tray (containing all live
saving equipments like defibrillator,
tracheostomy set, AMBU bag etc)
7. Immediate post operative phase
It’s the period of first few hours after surgery when the
client is recovering from the effect of anesthesia. Here
the nurse has to keep all emergency equipment and
drugs etc. for the use of patient’s recovery from
anesthesia and on admission to postoperative unit, the
nurse performs the following:
• Assess airway patency and support as needed, cramp,
strider, wheezes or decreased breathe sounds.
8. Contd..
• Applies humidified oxygen via nasal cannula or
facemask (unless otherwise ordered)
• Records vital signs (blood pressure, heart rate,
strength and regularity, respiratory rate and
depth, oxygen saturation, skin color and
temperature)
• Assess the client’s level of consciousness, muscle
strength and ability to follow commands
• Observe the clients IV infusions, drains and
special equipment.
9. Contd..
• Remain at the client’s beside, continuing close
observation of the client’s conditions.
• After the client has been ascertained, the nurse
receives verbal report regarding surgery in detail,
i.e
type of anesthesia,
sedative,
All annoying incident happened and
everything about surgery
documents the reliable and retainable
information for further care
10. Contd..
It is very important that nursing intervention
associated with immediate recovery (ABCs) are as
follows:
• Circulation
• Airway
• Breathing
• Consciousness
• System reviews
11. Information given to PACU nurse by
perioperative Team
Operative procedure performed
Medical diagnosis, pertinent medical history
and daily medications
Vital signs
Blood loss, fluid replacement
Urine output and presence of indwelling
catheter
Complications during surgery
12. Contd..
Anesthetic agents, narcotics, neuromuscular
blocking agents or antibiotics
Drains inserted and their location and purpose
Physicians order to be carried out properly
13. Transfer from PACU to Postoperative
Ward
After the operation, a member of surgical team
wipes off excess blood, skin preparation, and
debris from the client’s skin and puts a clean
gown and blankets on the client.
- Enough spacing is a must for moving or
transferring a client
- Avoid rapid movements when changing the
client’s position (predispose development of
hypotension)
14. Contd..
• When patient is prone to nausea, confusion, and
hypotension watch for kink of tubes or dislodge iv
or catheter tubing, drains, or other equipment
during the transfer.
• Maintain client’s modesty during tranfer.
• Avoid rough handling which may damage fragile
skin.
• After transfer to stretcher, the client is covered
with warm blankets and secured with a safety
belt. (make sure side rails are locked up)
15. Contd..
In some cases certain clients are transferred
directly from operating room to intensive care
unit (ICU) for continued specialized care and
constant nursing supervision. The following are
possible candidates for immediate transfer to
intensive care:
• Clients at risk of severe complication who remain
unstable for a long time after completion of
procedure and who will probably have a
complicated postoperative course.
16. Contd..
• Clients who have undergone major surgery
(eg. Resection of aortic aneurysm, open heart
surgery, kidney transplantation)
• Clients who have suffered a cardiac or
respiratory arrest during or immediately
following surgery
• Clients who came to surgery from the
intensive care unit and will return there.
17. Contd..
Note
Family members should always be informed
or notified of the client’s status and where the
client will be immediately after surgery. The
surgeon usually discusses the surgical
procedure, outcomes and postoperative
course with family members.
18. Nursing care in post anesthetic care
unit
• Protect the airway
• Maintain normal blood pressure
• Monitor for return of consciousness
• Assess for return of sensation and motion
• Assess for normothermia
• Assess for perfusion
• Assess the surgical site
• Promote fluid and electrolyte balance
